Bladder cancer surgery is a surgical procedure in which part or all of the bladder is removed in order to treat the cancer. Bladder cancer surgery is a popular option because it completely removes the tumor, reduces the chances of recurrence, and improves survival in advanced patients.
What is a bladder cancer surgery?
Bladder cancer occurs when cells in the bladder begin to grow uncontrollably, as the bladder is a hollow balloon-shaped organ in the lower part of the abdomen that stores urine, bladder cancer is a cancer found anywhere in the bladder and there are two main types of it Partial resection, which removes part of the bladder and is used in early cases and aims to remove the tumor while preserving bladder function as much as possible, while total resection is to remove the entire bladder and is used in advanced cases or when the tumor has spread widely.
When is a bladder cancer surgery recommended?
Many different conditions require bladder cancer surgery, including:
- If bladder cancer invades the muscle layer of the bladder wall or the surrounding lymph nodes
- Advanced, very large, or widespread cancer
- Failure to respond to radiation or chemotherapy
- Tumor recurrence after prior treatment
Types of bladder cancer surgery
| Type of surgery | Description | Features | Disadvantages |
|---|---|---|---|
| Total ablation | Complete removal of the bladder with the creation of a urinary diversion (such as an external bag or replacement bladder). | A radical treatment for advanced cancer that minimizes the risk of relapse. | It has a significant impact on the patient’s life as it requires a permanent change in lifestyle. |
| Partial resection | Removing part of the bladder only when there is a limited tumor in a specific area. | Preserving normal bladder function may result in healing without a urinary diversion. | Limited application, as there may be a chance of the tumor returning in the future. |
| Laparoscopic surgery | A surgical procedure using tiny instruments inserted through small incisions in the abdomen. | High accuracy and better control during the procedure minimize potential complications. | It may provide less accuracy in complex cases compared to advanced techniques. |
| Robotic surgery | An advanced technique for laparoscopic surgery that uses a robotic arm with 3D vision. | High accuracy and better control during the procedure and minimize potential complications. | It is more expensive and requires advanced equipment and specialized surgical expertise. |
Pre-operative preparations
- Most doctors recommend that you stop taking aspirin, ibuprofen, naproxen, or blood thinners for one week before surgery because these medications can cause bleeding.
- About one to two weeks before surgery, you may have a pre-op appointment or consultation to make sure that anesthesia is the right choice. Your doctor may also recommend a pre-surgical urine procedure.
- You will not be able to eat or drink anything but water after midnight the night before surgery unless otherwise instructed by your doctor, and it is important to follow these instructions.
- You will also need a friend or family member to drive you home after the procedure
How is bladder cancer surgery performed?
- General anesthesia so that the patient does not feel any pain, and may use regional anesthesia, which numbs the lower half of the patient
- Inserting a long, thin instrument through the urethra
- A type of cystoscope is inserted through the urethra, which has a small telescope that the doctor can see and a wire loop at the end that is used to remove any abnormal tissue or tumors
- The removed tissue is sent to the lab for testing
- After the tumor is removed, further steps may be taken to try to make sure there is no more cancer in the bladder wall. For example, the tissue in the area where the tumor is located may be burned with an electric current, or a high-energy laser may be used to kill the cancer cells
Reconstructing the urinary system after surgery
Urinary reconstruction after cystectomy surgery usually aims to restore urinary function and improve the patient’s quality of life.
The ileal conduit is used when a pathway is created that redirects urine from the urethra to prevent loss of control, and is considered a conservative option in certain cases. The new bladder can be built using a section of the intestine to form an alternative chamber that mimics the function of the natural bladder and allows the patient to control urination. The external bag is an option in which urine is diverted to a bag worn externally by the patient and is often used in cases that do not allow direct bladder reconstruction, where the choice between them depends on the patient’s condition and the recommendations of the medical team.
Post-surgery and possible complications
Risks of the operation
- Reactions to anesthesia
- Bleeding
- Blood clots in the legs or lungs
- Damage to neighboring organs
- Possible infection
Effects of the procedure on urination
- Partial resection: Bladder capacity is reduced, which increases the frequency of urination.
- Total resection: Requires reconstruction of the urinary system; this involves creating a new pathway to void urine via urostomy or using a catheter, with the potential for infection, urine leakage, incontinence, obstructive stone formation, and changes in fluid absorption.
Sexual implications for men and women
- Removal of the prostate and seminal vesicles, resulting in an absence of semen (dry orgasm)
- Nerve damage can affect erections, especially in the elderly
- Anterior vaginectomy reduces comfort during intercourse
- Possible damage to nerves or blood vessels, affecting sexual function
- Vaginal reconstruction as a solution to improve sexual comfort
In conclusion, bladder cancer surgery is a vital and necessary surgical procedure to address early and advanced cancer, where the focus is on removing all cancer cells with precision. Modern techniques rely on performing bladder cancer surgery using advanced methods that minimize risks and reduce complications. During bladder cancer surgery, the medical team uses the latest imaging and monitoring techniques to ensure that cystectomy is performed with complete success.
Adherence to follow-up instructions after bladder cancer removal plays an important role in preventing the disease from returning. Bladder cancer surgery remains a symbol of the progress in oncological care and offers hope for long-term survival and improved quality of life.
Sources:
- American Cancer Society. (n.d.). Surgery. Retrieved June 14, 2025
- Canadian Cancer Society. (n.d.). Surgery. Retrieved June 14, 2025
